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2 Objectives: Participants will have an understanding of the challenges Native Americans and minorities face with Evidence Based Practices. Participants will have an understanding of work in process with current efforts culturally validating Practices Based On Evidence for Native American communities. Participants will have an opportunity to test a tool being considered to measure Tribal practices currently been implemented in Native American communities.

3 Under this definition tribal, and minority programs would only qualify as Level III or IV programs. Since one of the key components of evidence best pratices is randomized studies, this would not align with cultural values. For example, the tribal cultural values of generosity and respect would not allow denial of services to community members. This may result in tribal programs being seen as less effective.

4 Some expectation and assumptions of the research/scientific community may not fit well within N.A. community. Experts in Native American communities are often elders. They carry the spiritual, cultural and intellectual wisdom of the community. - Credentials are very important for the experts in the scientific arena. - Indian Way does not necessarily include university training, college degrees or publications and recognition for research activities. Does include a specific set of behaviors and wisdom that is recognized by the community as being valued and based on teachings. Developing Culturally-Based Promising Practices for Native American Communities 2001 White Bison, Inc. Modified by C. Cruz with permission

5 Theories in science-based (also called evidence-based or research-based) programs are based on observations, assumptions and valued of Western European cultures. N.A. communities teachings provide basis for understanding what works and why. These teachings are accessed by the Elders and have been the basis for healthy communities for many centuries. Developing Culturally-Based Promising Practices for Native American Communities 2001 White Bison, Inc. Modified by C. Cruz with permission

6 Within the framework of science, what can be observed is what is counted. However within the context of the Indian Way, not only is there the seen world, but the unseen world as well. When things are out of harmony in the unseen world, this disharmony is reflected in the seen world. Intervening only in the areas that can be seen is insufficient to create change from the perspective of the traditional N.A. teaching. Developing Culturally-Based Promising Practices for Native American Communities 2001 White Bison, Inc. Modified by C. Cruz with permission

7 Another issue with science-based programs is the need for random sampling and control groups that are integral to the quantitative methods for most often used to ensure generalizability. In the Indian Way an opportunity is to be made to everyone in the community. Most of the communities are too small to support the rigorous expectations of random sampling. Also they are too closely knit to prevent those in control groups from communicating with those in the experimental groups. To provide an intervention to some members of the community while denying it to others creates problems that can undermine the success of the program all together. Developing Culturally-Based Promising Practices for Native American Communities 2001 White Bison, Inc. Modified by C. Cruz with permission

8 Important to note that while N.A. communities have different definitions and different cultural values, we are just as interested in providing programs that work and that are based upon sound principals, laws and values. The opportunity that we have is to create a bridge of understanding between our cultures so that we can define a set of criteria that demonstrates what works in the Indian Way and then define measurement systems and accountability systems that will demonstrate the effectiveness of the programs that are implemented in N.A. communities. Developing Culturally-Based Promising Practices for Native American Communities 2001 White Bison, Inc. Modified by C. Cruz with permission

9 Create a Bridge Between Science and N.A. Culture Validation Scientific Validated Cultural Validated Transparency Standardization Replication Research Outcomes Study design Fidelity Longevity in historical tribal history Tribal Based Practice manual Cultural replication Within tribe and/or other tribes Meets Tribal principles Outcomes Does not apply According to Tribe/Tribal Nation Caroline M. Cruz

10 Transparency: Criteria: How to find evidence; What qualifies as evidence; How to judge quality of evidence. Process: Who reviews the evidence? Should be open for observation by public description. Is the research understandable and fully described so it can be replicated by others? N.A Transparency: Does practice have longevity in historical tribal history? Documented and/or oral history. Can it pass the Three Grandmothers test?. Caroline M. Cruz

11 Standardization: Intervention must be standardized so that it can be reliably replicated elsewhere by others. Standardization typically involves a description that clearly defines the essential elements of the practice, as evidenced in a manual or toolkit. N.A. Standardization: Capable of creating Tribal Based Practice manuals. Practices that are culturally relevant, culturally appropriate, and designed according to the Indian Way. Should Native American Tribes, Nations, Villages create manuals? Passing from one generation to the next has been in existence for centuries. Caroline M. Cruz

12 Replication: Replication of research findings means that more than one study and more than one group of researchers have found similar positive effects resulting from the practice. N.A. Replication: Cultural replication. Since all Tribes are not the same are we talking about similar Tribes, within Tribes, or just replication? Programs that have been developed and implemented according to the Indian Way and have been passed on to others and continue to be implemented and utilized can be defined as cultural replication. Our Elders and community members will let us know if we are not doing it right. Caroline M. Cruz

13 Research: Accumulated scientific evidence based on randomized controlled trials. Quasi-experimental studies. Research should be published in two or more peer-reviewed journals. N.A. research: Meets Tribal Principals. Experts in Native American communities are often elders. They carry the spiritual, cultural and intellectual wisdom of the community. N.A. communities teachings provide basis for under-standing what works and why. These teachings are accessed by the Elders and have been the basis for healthy communities for many centuries. Caroline M. Cruz

14 Meaningful outcomes: Effective interventions must be shown that they can help consumers to achieve important goals or outcomes related to impairments and/or risk factors. N.A. Outcomes: Do people show up for one time and then never come again? Or do they come, tell their friends about it, and bring others to participate? Do community members, participants, clients share feedback. This is the story of the program. It can be documented. Important to track these measurements, how they change over time. Caroline M. Cruz

15 Fidelity Scale: A fidelity scale is used to verify that an intervention is being implemented in a manner consistent with the treatment model or the research that produced the practice. The scale has been shown to be reliable and valid. N.A. Fidelity Scale: Our Elders within our community, our teachers and the Three elder women test is our fidelity scale. The Elders are our gauge for how we are doing. Caroline M. Cruz

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